上海市卫生总费用来源法与机构法核算结果差异原因分析  

Analysis on the Differences between Calculation Result by Resource Method and by Institution Method of Total Health Expenditure in Shanghai

作　　者：金春林[1,2] 王力男[1,2] 李芬[1,2] 

机构地区：[1]上海市卫生发展研究中心 [2]上海市医学科学技术情报研究所,上海200040

出　　处：《中国卫生经济》2013年第8期14-16,共3页Chinese Health Economics

基　　金：上海市财政支持项目(201242500091-10019);美国中华医学基金会卫生系统研究与政策转化合作项目(11-061)

摘　　要：目的:找出上海市卫生总费用来源法和机构法核算结果存在差异的原因。方法:通过分析卫生资金筹集和分配过程,以2011年上海市卫生总费用相关数据为例,对来源法和机构法差异原因进行数据修正。结果:外来就医、医保基金结余和OOP核算方法的调整3种因素解释了两种核算结果差异总额122.2亿中的94.0亿。结论:应从合理规划卫生资源、加强医保基金收支管理和降低居民医疗负担等方面完善卫生资金的运行。Objective： To find the reason for the differences between calculation results by resource and by institution of total health expenditure in Shanghai. Methods： By analyzing the process of health financing and distribution, take Shanghai＇s relevant data in 2011 for example, amend the differences between the two methods. Results： As the three adjustment factors of accounting methods, patients from allopatry, health insurance fund balance, and OOP accounting method explain the total price variance of two calculation results： 9.40 billion out of 12.22 billion. Conclusion： Organizing health resource reasonably, enhancing medical fund balancing management and reducing the medical treatment burden of residents are needed to implement health fund operation.

关 键 词：外来就医 医保基金结余 个人现金卫生支出 

分 类 号：R197.1[医药卫生—卫生事业管理]